Management of severe complications in Behçet's disease with TNF inhibitors

Expert Opin Biol Ther. 2017 Jul;17(7):853-859. doi: 10.1080/14712598.2017.1328496. Epub 2017 May 19.

Abstract

The efficacy of anti-TNFα agents has been recently evaluated in many studies in Behçet's disease (BD), particularly in ocular and life-threatening manifestations such as neurological and vascular disease. Areas covered: The following article aims to summarize the currently available efficacy and safety data of anti-TNFα agents in BD. Expert opinion: Most studies have shown dramatic and rapid efficacy with anti-TNFα agents on the main BD-associated issues including posterior uveitis, gastro-intestinal and neurological complications as well as major vessel disease. Experts in the field do recommend the use of anti-TNF agents (either infliximab or adalimumab) as a first-line therapy in severe posterior uveitis in BD and now use anti-TNFα treatment in BD-associated life threatening manifestations. However, data is mainly based on retrospective cohorts or open-label prospective studies. Controlled studies (versus conventional immunosuppressants such as azathioprine and cyclophosphamide) are warranted to properly evaluate their efficacy as first line therapeutic in life-threatening manifestations of BD.

Keywords: Anti-TNFα agents; Behcet’s disease (BD); adalimumab (ADA); infliximab (IFX); treatment.

Publication types

  • Review

MeSH terms

  • Adalimumab / therapeutic use
  • Antibodies, Monoclonal / immunology
  • Antibodies, Monoclonal / therapeutic use*
  • Antimetabolites, Antineoplastic / therapeutic use
  • Azathioprine / therapeutic use
  • Behcet Syndrome / drug therapy*
  • Behcet Syndrome / metabolism
  • Behcet Syndrome / pathology
  • Humans
  • Infliximab / therapeutic use
  • Tumor Necrosis Factor Inhibitors*
  • Tumor Necrosis Factors / immunology
  • Tumor Necrosis Factors / metabolism

Substances

  • Antibodies, Monoclonal
  • Antimetabolites, Antineoplastic
  • Tumor Necrosis Factor Inhibitors
  • Tumor Necrosis Factors
  • Infliximab
  • Adalimumab
  • Azathioprine